Treat-to-target in systemic lupus erythematosus: advancing towards its implementation

Agner R. Parra Sánchez, Alexandre E. Voskuyl, Ronald F. van Vollenhoven*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


The treat-to-target (T2T) concept has improved outcomes for patients with diabetes, hypertension and rheumatoid arthritis. This therapeutic strategy involves choosing a well-defined, relevant target, taking therapeutic steps, evaluating whether the target has been achieved, and taking action if it has not. The T2T principle has been embraced by systemic lupus erythematosus (SLE) experts, but measurable and achievable outcomes, and therapeutic options, are needed to make this approach possible in practice. Considerable evidence has been generated regarding meaningful ‘state’ outcomes for SLE. Low disease activity has been defined and studied, and the most aspirational goal, remission, has been defined by the Definition of Remission in SLE task force. By contrast, current therapeutic options in SLE are limited, and more effective and safer therapies are urgently needed. Fortunately, clinical trial activity in SLE has been unprecedented, and encouraging results have been seen for novel therapies, including biologic and small-molecule agents. Thus, with the expected advent of such treatments, it is likely that sufficiently diverse therapies for SLE will be available in the foreseeable future, allowing the routine implementation of T2T approaches in the care of patients with SLE.
Original languageEnglish
Pages (from-to)146-157
Number of pages12
JournalNature Reviews Rheumatology
Issue number3
Publication statusPublished - 1 Mar 2022

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